Prospective Community Studies in Developing Countries

7 Longitudinal Community Health Research
for Equity and Accountability in Primary
Health Care in Haiti

GRETCHEN BERGGREN,
WARREN BERGGREN, HENRI MENAGER, AND
EDDY GENECE

Man is not a machine that one can reconstruct as occasion demands, upon
other lines for quite other ends, in the hope that it win then proceed to
function in a totally different way, just as normally as before. Man bears
his age-long history with him; in his very structure is written the history of
mankind.

Carl G. Jung

7.1 Introduction to Two Longitudinal Community Health Research
(LCHR) Studies In Rural Haiti

The investigators undertook two longitudinal community health research
(LCHR) studies to assess primary health-care activities in rural Haiti. The
work was motivated by the need to demonstrate that selected interventions
can reduce the impact on the community of the most frequent preventable,
fatal and crippling diseases. Methods developed for surveillance also brought
equity and accountability to primary health care at the community level.

The impetus for these studies originally came from the late Dr William
Larimer Mellon, Jr., founder of the rural Hôpital Albert Schweitzer (HAS), Haiti, who increasingly advocated preventive medicine within a community
development context. In 1968 public-health practitioners joined hospital staff
members to develop outreach projects which could bring equity and coverage
in preventive medicine to the district of 100,000 served by the hospital. A small
LCHR project began at the same time in a defined population near the hospital in order to inform decision-makers about the most frequent preventable
fatal and disabling diseases. Data gathered by the project could help officials
who set priorities for community health from a limited budget. Initial methods

The studies were supported by the Grant Foundation of the Albert Schweitzer Hospital of Haiti,
the Rockefeller Foundation, the Division of Family Hygiene of the Government of Haiti, the Batelle Memorial Institute, Bread for the World of Germany, IDRC/ Canada, and the UNFPA
through its funding of Haiti's Division of Family Hygiene.

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